DAVID A WIEGAND MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036065032

License Status

NOT RENEWED

Business

First Name

DAVID A

Last Name

WIEGAND

Suffix

Business Name

DAVID A WIEGAND MD

Original Issue Date

08/11/1982

Effective Date

08/11/1982

Expiration Date

07/31/1984

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006